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Mello M, Fusaro M, Aglioti SM, Minio-Paluello I. Exploring social touch in autistic and non-autistic adults via a self-report body-painting task: The role of sex, social context and body area. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1985-2001. [PMID: 38179707 DOI: 10.1177/13623613231218314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
LAY ABSTRACT What is already known about the topic?At least in neurotypical individuals, social touch represents an important channel for emotional communication associated with social bonding and pain/anxiety modulation. Autistic adults report to avoid social touch more and to have different tactile sensitivity than their non-autistic comparisons.What this paper adds?Few studies specifically investigated social touch in autistic individuals, and none of them examined the role of participants' sex, social context in which social touch occurs, and specific body areas being touched. In our study, adult participants reported how pleasant, erogenous and appropriate they would consider touches delivered by another person over their entire body in intimate (date), friendly (dance class) and professional (physiotherapy-massage session) social contexts. Autistic adults reported social touch to be less pleasant, erogenous and appropriate specifically in intimate and friendly social contexts and in body areas typically touched in these situations. Importantly, autistic females seem more at risk to experience unpleasant social touch as, although they considered it more unpleasant than non-autistic females and autistic males, they did consider it similarly appropriate in professional social contexts where touch is normed to be socially appropriate.Implications for practice, research or policyOur results might improve awareness and understanding about autistic adults' different, and often more discomforting, experience of social touch and thus help consider and respect it during everyday social interactions. Our results might also benefit future research investigating, for instance, the neural underpinnings of social touch differences in autism or aiming at developing support for autistic individuals seeking help in the diverse spheres of social touch.
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Affiliation(s)
- Manuel Mello
- Sapienza University of Rome, and Istituto Italiano di Tecnologia (IIT), Rome, Italy
- Santa Lucia Foundation IRCCS, Rome, Italy
| | | | - Salvatore Maria Aglioti
- Sapienza University of Rome, and Istituto Italiano di Tecnologia (IIT), Rome, Italy
- Santa Lucia Foundation IRCCS, Rome, Italy
| | - Ilaria Minio-Paluello
- National Research Council, Institute of Cognitive Sciences and Technologies, Rome, Italy
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Adrien V, Bosc N, Peccia Galletto C, Diot T, Claverie D, Reggente N, Trousselard M, Bui E, Baubet T, Schoeller F. Enhancing Agency in Posttraumatic Stress Disorder Therapies Through Sensorimotor Technologies. J Med Internet Res 2024; 26:e58390. [PMID: 38742989 PMCID: PMC11250045 DOI: 10.2196/58390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/17/2024] [Accepted: 05/02/2024] [Indexed: 05/16/2024] Open
Abstract
Posttraumatic stress disorder (PTSD) is a significant public health concern, with only a third of patients recovering within a year of treatment. While PTSD often disrupts the sense of body ownership and sense of agency (SA), attention to the SA in trauma has been lacking. This perspective paper explores the loss of the SA in PTSD and its relevance in the development of symptoms. Trauma is viewed as a breakdown of the SA, related to a freeze response, with peritraumatic dissociation increasing the risk of PTSD. Drawing from embodied cognition, we propose an enactive perspective of PTSD, suggesting therapies that restore the SA through direct engagement with the body and environment. We discuss the potential of agency-based therapies and innovative technologies such as gesture sonification, which translates body movements into sounds to enhance the SA. Gesture sonification offers a screen-free, noninvasive approach that could complement existing trauma-focused therapies. We emphasize the need for interdisciplinary collaboration and clinical research to further explore these approaches in preventing and treating PTSD.
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Affiliation(s)
- Vladimir Adrien
- Department of Infectious and Tropical Diseases, Avicenne Hospital, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
- Institute of Psychiatry and Neuroscience of Paris, Inserm UMR-S 1266, Université Paris Cité, Paris, France
- Department of Psychopathology, Avicenne Hospital, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
| | - Nicolas Bosc
- Department of Psychopathology, Avicenne Hospital, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
| | | | - Thomas Diot
- Department of Adult Psychiatry, Impact, Mondor Hospital, AP-HP, Université Paris-Est Créteil, Créteil, France
| | - Damien Claverie
- Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Nicco Reggente
- Institute for Advanced Consciousness Studies, Santa Monica, CA, United States
| | - Marion Trousselard
- Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
- INSPIIRE, Inserm UMR 1319, Université de Lorraine, Nancy, France
- ADES, CNRS UMR 7268, Aix-Marseille Université, Marseille, France
| | - Eric Bui
- Department of Psychiatry, Caen Normandy University Hospital, Normandie Université, Caen, France
- Physiopathology and Imaging of Neurological Disorders, UNICAEN, Inserm UMR-S 1237, Normandie Université, Caen, France
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Thierry Baubet
- Department of Psychopathology, Avicenne Hospital, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
- Unité Transversale de Psychogénèse et Psychopathologie, Université Sorbonne Paris Nord, Villetaneuse, France
- Centre National de Ressources et de Résilience, Lille, France
| | - Félix Schoeller
- Institute for Advanced Consciousness Studies, Santa Monica, CA, United States
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, United States
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Niemi KJ, Huovinen A, Jaakkola E, Glerean E, Nummenmaa L, Joutsa J. Bodily Maps of Symptoms and Emotions in Parkinson's Disease. Mov Disord 2024; 39:1037-1043. [PMID: 38586892 DOI: 10.1002/mds.29785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/22/2024] [Accepted: 02/27/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND Emotions are reflected in bodily sensations, and these reflections are abnormal in psychiatric conditions. However, emotion-related bodily sensations have not been studied in neurological disorders. OBJECTIVE The aim of this study was to investigate whether Parkinson's disease (PD) is associated with altered bodily representations of emotions. METHODS Symptoms and emotion-related sensations were investigated in 380 patients with PD and 79 control subjects, using a topographical self-report method, termed body sensation mapping. The bodily mapping data were analyzed with pixelwise generalized linear models and principal component analyses. RESULTS Bodily maps of symptoms showed characteristic patterns of PD motor symptom distributions. Compared with control subjects, PD patients showed decreased parasternal sensation of anger, and longer PD symptom duration was associated with increased abdominal sensation of anger (PFWE < 0.05). The PD-related sensation patterns were abnormal across all basic emotions (P < 0.05). CONCLUSIONS The results demonstrate altered bodily maps of emotions in PD, providing novel insight into the nonmotor effects of PD. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Kalle J Niemi
- Turku Brain and Mind Center, University of Turku, Turku, Finland
- Clinical Neurosciences, University of Turku, Turku, Finland
- Neurocenter, Turku University Hospital, Turku, Finland
| | - Annu Huovinen
- Turku Brain and Mind Center, University of Turku, Turku, Finland
- Clinical Neurosciences, University of Turku, Turku, Finland
| | - Elina Jaakkola
- Turku Brain and Mind Center, University of Turku, Turku, Finland
- Clinical Neurosciences, University of Turku, Turku, Finland
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Enrico Glerean
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Lauri Nummenmaa
- Turku PET Centre, Turku University Hospital, Turku, Finland
- Department of Psychology, University of Turku, Turku, Finland
| | - Juho Joutsa
- Turku Brain and Mind Center, University of Turku, Turku, Finland
- Clinical Neurosciences, University of Turku, Turku, Finland
- Neurocenter, Turku University Hospital, Turku, Finland
- Turku PET Centre, Turku University Hospital, Turku, Finland
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Dutcher EG, Verosky SC, Mendes WB, Mayer SE. Localizing somatic symptoms associated with childhood maltreatment. Proc Natl Acad Sci U S A 2024; 121:e2318128121. [PMID: 38687795 PMCID: PMC11087768 DOI: 10.1073/pnas.2318128121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 04/01/2024] [Indexed: 05/02/2024] Open
Abstract
Childhood maltreatment has been linked to adult somatic symptoms, although this has rarely been examined in daily life. Furthermore, the localization of somatization associated with childhood maltreatment and its subtypes is unknown. This large-scale experience sampling study used body maps to examine the relationships between childhood maltreatment, its subtypes, and the intensity and location of negative somatic sensations in daily life. Participants (N = 2,234; 33% female and 67% male) were part of MyBPLab 2.0, a study conducted using a bespoke mobile phone application. Four categories of childhood maltreatment (emotional abuse, emotional neglect, physical abuse, and physical neglect) were measured using the Childhood Trauma Questionnaire. Using gender-matched human silhouettes, participants indicated the location and intensity of feelings of negative activation in the body. Childhood maltreatment generally and its four measured subtypes were all positively associated with heightened negative activation on both the front and back body maps. For females, total childhood maltreatment was associated with negative activation in the abdomen and lower back, while for males, the association was localized to the lower back. Similarly, each of the four subscales had localized associations with negative activation in the abdomen and lower back in females and lower back in males, except for emotional abuse, which was also associated with negative activation in the abdomen in males. These associations likely reflect increased somatization in individuals exposed to childhood maltreatment, suggesting a role for psychotherapeutic interventions in alleviating associated distress.
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Affiliation(s)
- Ethan G. Dutcher
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA94107
| | | | | | - Stefanie E. Mayer
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA94107
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Torregrossa LJ, Liu J, Armstrong K, Heckers S, Sheffield JM. Interplay between childhood trauma, bodily self-disturbances, and clinical phenomena in schizophrenia spectrum disorders: A network analysis. Schizophr Res 2024; 266:107-115. [PMID: 38394867 DOI: 10.1016/j.schres.2024.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/06/2024] [Accepted: 02/17/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Bodily self-disturbances have long been considered central to schizophrenia. Exposure to childhood trauma has been linked to the development of both psychosis and bodily self-disturbances, yet little work has examined the role of bodily self-disturbances in the relationship between childhood trauma and schizophrenia symptomatology. This study uses network analysis to bridge this gap. METHODS Networks were constructed to examine relationships between schizophrenia symptoms (Positive and Negative Symptom Scale; PANSS), bodily self-disturbances (Perceptual Aberration Scale; PAS), and self-reported exposure to childhood trauma (Childhood Trauma Questionnaire, Short-Form; CTQ-SF) in 152 people with a schizophrenia-spectrum disorder. Shortest path and bridge analyses were conducted to assess the role of bodily self-disturbances in linking childhood trauma to schizophrenia symptomatology. Three networks were constructed: 1) PAS, childhood trauma, and PANSS sub-scale composites (positive, negative, general); 2) PAS, childhood trauma, and positive symptoms, 3) PAS, childhood trauma, and distress symptoms. RESULTS Shortest path analysis revealed that bodily self-disturbances were on the shortest path between childhood trauma and positive and general symptoms (Network 1), between trauma and hallucinations (Network 2), and between trauma and depression (Network 3). Bodily self-disturbances were also found to serve as a bridge between childhood trauma and positive symptoms of schizophrenia, particularly delusions and hallucinations. CONCLUSIONS Using a novel, data-driven approach, we showed that bodily self-disturbances play a key role in linking childhood trauma to positive and co-morbid affective symptoms of schizophrenia. Threat experiences (i.e., abuse) specifically relate to bodily self-disturbances and psychotic symptoms.
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Affiliation(s)
- Lénie J Torregrossa
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences, United States of America.
| | - Jinyuan Liu
- Vanderbilt University Medical Center, Department of Biostatistics, United States of America
| | - Kristan Armstrong
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences, United States of America
| | - Stephan Heckers
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences, United States of America
| | - Julia M Sheffield
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences, United States of America
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Herman AM, Wypych M, Michałowski J, Marchewka A. Bodily confusion: Lower differentiation of emotional and physiological states in student alcohol users. Addict Biol 2024; 29:e13364. [PMID: 38380800 PMCID: PMC10898845 DOI: 10.1111/adb.13364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/19/2023] [Accepted: 11/23/2023] [Indexed: 02/22/2024]
Abstract
BACKGROUND Alexithymia, difficulty in recognising and naming emotions, is common among people who use alcohol. There is also emerging evidence that people with alexithymia are unable to distinguish emotions from non-emotional physiological states. The project aimed to test if alcohol use is related to the way student drinkers experience emotions and physiological states in the body. METHODS We employed a novel method to study bodily sensations related to emotions and physiological states in the context of alcohol use: the emBODY tool, which allowed participants to mark areas of the body in which they experience various emotions and physiological states. RESULTS Students who showed a hazardous pattern of alcohol use (alcohol use disorders identification test [AUDIT] score ≥ 7, N = 91), overall, presented higher alexithymia levels and coloured larger areas for emotions and physiological states (showed less specificity) than those who show low-risk alcohol consumption (AUDIT ≤ 4, N = 90). Moreover, statistical classifiers distinguished feeling-specific maps less accurately for hazardous drinkers than low-risk drinkers [F(1,1998) = 441.16; p < 0.001], confirming that higher alcohol use is related to higher confusion of emotional and non-emotional bodily feelings. CONCLUSIONS Plausibly, this increased bodily confusion drives alcohol consumption: alcohol may serve as a means of dealing with undifferentiated changes in psychophysiological arousal accompanying emotional states.
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Affiliation(s)
- Aleksandra M. Herman
- Laboratory of Brain Imaging, Nencki Institute of Experimental BiologyPolish Academy of SciencesWarsawPoland
| | - Marek Wypych
- Laboratory of Brain Imaging, Nencki Institute of Experimental BiologyPolish Academy of SciencesWarsawPoland
| | - Jarosław Michałowski
- Laboratory of Affective Neuroscience in Poznań, Faculty of Psychology and LawSWPS University of Social Sciences and HumanitiesPoznańPoland
| | - Artur Marchewka
- Laboratory of Brain Imaging, Nencki Institute of Experimental BiologyPolish Academy of SciencesWarsawPoland
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Beals K, Torregrossa LJ, Smith R, Lane RD, Sheffield JM. Impaired emotional awareness is associated with childhood maltreatment exposure and positive symptoms in schizophrenia. Front Psychiatry 2024; 14:1325617. [PMID: 38283891 PMCID: PMC10811959 DOI: 10.3389/fpsyt.2023.1325617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 12/14/2023] [Indexed: 01/30/2024] Open
Abstract
Objectives Evidence suggests that emotional awareness-the ability to identify and label emotions-may be impaired in schizophrenia and related to positive symptom severity. Exposure to childhood maltreatment is a risk factor for both low emotional awareness and positive symptoms. Methods The current investigation examines associations between a performance-based measure of emotional awareness, positive symptom severity, and childhood maltreatment exposure in 44 individuals with a schizophrenia-spectrum disorder and 48 healthy comparison participants using the electronic Levels of Emotional Awareness Scale (eLEAS), Positive and Negative Syndrome Scale (PANSS) and Childhood Trauma Questionnaire (CTQ). Results Patients demonstrated significant deficits in emotional awareness overall, which was true for both self and others. In patients, lower emotional awareness was significantly associated with more severe positive symptoms. Emotional awareness was significantly impaired in patients with schizophrenia with self-reported maltreatment exposure, relative to other groups. Severity of maltreatment was not significantly associated with emotional awareness or positive symptoms when looking continuously, and there was no significant indirect effect. Conclusion These data suggest that emotional awareness impairments observed in schizophrenia may be exacerbated by exposure to childhood maltreatment, possibly putting individuals at greater risk for experiencing positive symptoms of psychosis.
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Affiliation(s)
- Kendall Beals
- Sheffield Lab, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
- Social Cognition and Recovery in Schizophrenia Lab, Department of Psychology, The University of Southern Mississippi, Hattiesburg, MS, United States
| | - Lénie J. Torregrossa
- Sheffield Lab, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Ryan Smith
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Richard David Lane
- Department of Psychiatry, University of Arizona, Tucson, AZ, United States
| | - Julia M. Sheffield
- Sheffield Lab, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
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Schoeller F, Horowitz AH, Jain A, Maes P, Reggente N, Christov-Moore L, Pezzulo G, Barca L, Allen M, Salomon R, Miller M, Di Lernia D, Riva G, Tsakiris M, Chalah MA, Klein A, Zhang B, Garcia T, Pollack U, Trousselard M, Verdonk C, Dumas G, Adrien V, Friston K. Interoceptive technologies for psychiatric interventions: From diagnosis to clinical applications. Neurosci Biobehav Rev 2024; 156:105478. [PMID: 38007168 DOI: 10.1016/j.neubiorev.2023.105478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 11/16/2023] [Accepted: 11/19/2023] [Indexed: 11/27/2023]
Abstract
Interoception-the perception of internal bodily signals-has emerged as an area of interest due to its implications in emotion and the prevalence of dysfunctional interoceptive processes across psychopathological conditions. Despite the importance of interoception in cognitive neuroscience and psychiatry, its experimental manipulation remains technically challenging. This is due to the invasive nature of existing methods, the limitation of self-report and unimodal measures of interoception, and the absence of standardized approaches across disparate fields. This article integrates diverse research efforts from psychology, physiology, psychiatry, and engineering to address this oversight. Following a general introduction to the neurophysiology of interoception as hierarchical predictive processing, we review the existing paradigms for manipulating interoception (e.g., interoceptive modulation), their underlying mechanisms (e.g., interoceptive conditioning), and clinical applications (e.g., interoceptive exposure). We suggest a classification for interoceptive technologies and discuss their potential for diagnosing and treating mental health disorders. Despite promising results, considerable work is still needed to develop standardized, validated measures of interoceptive function across domains and before these technologies can translate safely and effectively to clinical settings.
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Affiliation(s)
- Felix Schoeller
- Fluid Interfaces Group, Media Lab, Massachusetts Institute of Technology, USA; Institute for Advanced Consciousness Studies, Santa Monica, CA, USA; Department Cognitive Sciences, University of Haifa, Israel.
| | - Adam Haar Horowitz
- Fluid Interfaces Group, Media Lab, Massachusetts Institute of Technology, USA; Center for Sleep and Cognition, Beth Israel Deaconess Medical Center, Harvard Medical School, USA
| | - Abhinandan Jain
- Fluid Interfaces Group, Media Lab, Massachusetts Institute of Technology, USA
| | - Pattie Maes
- Fluid Interfaces Group, Media Lab, Massachusetts Institute of Technology, USA
| | - Nicco Reggente
- Institute for Advanced Consciousness Studies, Santa Monica, CA, USA
| | | | - Giovanni Pezzulo
- Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy
| | - Laura Barca
- Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy
| | - Micah Allen
- Center of Functionally Integrative Neuroscience, Aarhus University, Denmark; Cambridge Psychiatry, University of Cambridge, UK
| | - Roy Salomon
- Department Cognitive Sciences, University of Haifa, Israel
| | - Mark Miller
- Center for Human Nature, Artificial Intelligence and Neuroscience, Hokkaido University, Japan
| | - Daniele Di Lernia
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy; Applied Technology for Neuro- Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Riva
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy; Applied Technology for Neuro- Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Manos Tsakiris
- The Warburg Institute, School of Advanced Study, University of London, UK; Department of Psychology, Royal Holloway, University of London, UK; Department of Behavioural and Cognitive Sciences, University of Luxembourg, Luxembourg
| | - Moussa A Chalah
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est Créteil, Créteil, France; Service de Physiologie - Explorations Fonctionnelles, Hôpital Henri Mondor, Créteil, France
| | - Arno Klein
- Child Mind Institute, New York City, USA
| | - Ben Zhang
- Institute for Advanced Consciousness Studies, Santa Monica, CA, USA
| | - Teresa Garcia
- Institute for Advanced Consciousness Studies, Santa Monica, CA, USA
| | - Ursula Pollack
- Institute for Advanced Consciousness Studies, Santa Monica, CA, USA
| | - Marion Trousselard
- Institut de Recherche Biomédicale des Armées, Place Général Valérie André, 91220 Brétigny-sur-Orge, France
| | - Charles Verdonk
- Institut de Recherche Biomédicale des Armées, Place Général Valérie André, 91220 Brétigny-sur-Orge, France
| | | | - Vladimir Adrien
- Infrastructure for Clinical Research in Neurosciences (iCRIN) Psychiatry, Paris Brain Institute, Paris, France; Department of Psychiatry, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, 75012 Paris, France
| | - Karl Friston
- Queen Sq, Institute of Neurology, UCL, London WC1N 3AR, UK
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Ojala J, Suvilehto JT, Nummenmaa L, Kalso E. Bodily maps of emotions and pain: tactile and hedonic sensitivity in healthy controls and patients experiencing chronic pain. Pain 2023; 164:2665-2674. [PMID: 37678245 PMCID: PMC10652713 DOI: 10.1097/j.pain.0000000000003027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 06/03/2023] [Accepted: 06/14/2023] [Indexed: 09/09/2023]
Abstract
ABSTRACT Pain is an unpleasant sensory and emotional experience. Both pain and emotions are warning signals against outside harm. Interoception, bodily sensations of emotions can be assessed with the emBODY tool where participants colour the body parts where they feel different emotions. Bodily maps of emotions (BMoE) have been shown to be similar between healthy individuals independent of age, sex, cultural background, and language. We used this tool to analyze how these body maps may differ between healthy controls and patients with persistent pain. We recruited 118 patients with chronic pain. An algorithm-selected matched controls from 2348 individuals who were recruited through social media, message boards, and student mailing lists. After providing background information, the participants completed the bodily topography colouring tasks with the emBODY tool using tablets (patients) and online using their own devices (controls), for pain, sensitivity for tactile, nociceptive and hedonic stimuli, and for the 6 basic emotions and a neutral state. Patients with pain coloured significantly larger areas for pain and more negative emotions. On the whole, their BMoEs were dampened compared with healthy controls. They also coloured more areas for nociceptive but not for tactile or hedonic sensitivity. Patients and controls marked different body areas as sensitive to nociceptive and tactile stimulation, but there was no difference in sensitivity to hedonic touch. Our findings suggest that emotional processing changes when pain persists, and this can be assessed with these colouring tasks. BMoEs may offer a new approach to assessing pain.
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Affiliation(s)
- Juhani Ojala
- Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Juulia T. Suvilehto
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Sweden
- AI Competence Center, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Lauri Nummenmaa
- Turku PET Centre, University of Turku, Finland
- Turku University Hospital and University of Turku, Finland
- Department of Psychology, University of Turku, Finland
| | - Eija Kalso
- Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- SleepWell Research Programme, Faculty of Medicine, University of Helsinki
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Park S. Schizophrenia in the mind, the brain and the body. Psychiatry Res 2023; 329:115547. [PMID: 37890408 DOI: 10.1016/j.psychres.2023.115547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/09/2023] [Accepted: 10/15/2023] [Indexed: 10/29/2023]
Abstract
The author describes three lines of research programs that have guided her goal of elucidating the etiology of schizophrenia: working memory and representational guidance of behavior, disrupted social cognition and bodily-self disturbances.
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Affiliation(s)
- Sohee Park
- Department of Psychology, Vanderbilt University, 111. 21st Ave S, Nashville, TN 37240, USA.
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Biondo J. Dance/movement therapy as a holistic approach to diminish health discrepancies and promote wellness for people with schizophrenia: a review of the literature. F1000Res 2023; 12:33. [PMID: 37593363 PMCID: PMC10429376 DOI: 10.12688/f1000research.127377.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/28/2023] [Indexed: 08/19/2023] Open
Abstract
Individuals with a diagnosis of schizophrenia face a myriad of obstacles to wellness, beginning with diagnostic discrepancies including over- and misdiagnoses on the schizophrenia spectrum. People with schizophrenia experience profound amounts of stigmatization from the general population, their healthcare providers, and even themselves. Such stigmatization creates a barrier for wellness, poorer prognoses, and often limits adherence to physical and mental healthcare. Moreover, it can exacerbate the already stifling symptomatology of their diagnoses, including specific bodily-related symptomatology. Oftentimes, a diagnosis of schizophrenia disrupts one's relationship with their body including a diminished mind-body connection, decreased interoceptive awareness, and thus unsuccessful intra- and interpersonal relationships. Some recent research suggests the use of mind-body therapies, however, if these practices are internalizing, they may not be appropriate for people with schizophrenia experiencing more acute symptomatology excluding them from treatment. Dance/movement therapy (DMT) is an embodied psychotherapeutic treatment option that can support participants in improving mind-body connection, social relationships, and self-regulatory skill development. Research on DMT has shown promising results for people with schizophrenia, however such research is limited and would benefit from increased studies that particularly measure the effects of DMT on mind-body connection and increased interoception for people with schizophrenia. Moreover, integrative and collaborative treatment models that couple DMT and biofeedback may further our understanding of the physiological and neurological effects of DMT interventions for people with schizophrenia and beyond. This review will examine the recent literature on health inequities for people with schizophrenia, their specific body-based disruptions and needs, and DMT as a promising treatment model, particularly when coupled with biofeedback.
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Affiliation(s)
- Jacelyn Biondo
- Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA, 19107, USA
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Torregrossa LJ, Blain SD, Snodgress MA, Park S. Multidimensional schizotypy and embodied emotions. Front Psychol 2023; 14:1141799. [PMID: 37179864 PMCID: PMC10166830 DOI: 10.3389/fpsyg.2023.1141799] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/03/2023] [Indexed: 05/15/2023] Open
Abstract
Background Disembodiment and socio-emotional deficits are core features of the schizophrenia spectrum from the prodromal stages to chronic illness. A recent study documented anomalous emotional embodiment in individuals with schizophrenia. Although bodily self disturbances have been shown to precede and predict psychosis onset in at-risk populations, the etiology of anomalous emotional embodiment remains largely unexplored. The present study investigated bodily maps of emotions in relation to schizotypy to extend our understanding of embodied emotions in the schizophrenia spectrum. Methods A total of 419 participants (312 female; 19.50 ± 1.22 years) completed a topographical body mapping task where they reported patterns of embodiment experienced in the context of eleven different emotions and a neutral state (EmBODY). Embodied emotions were investigated in relation to multidimensional schizotypy. Results Individuals with elevated negative schizotypy experienced embodied emotions with higher intensity (r = 0.16, p = 0.003) but lower clarity (i.e., endorsing activation and deactivation in the same bodily location; β = -0.28, 95% CI [-0.54, -0.03], Z = 2.25, p=0.02) and endorsed more incongruent bodily sensations of emotions (i.e., reporting bodily activation in the context of a low-arousal emotion, r = 0.12, p = 0.05; reporting bodily deactivation in the context of high-arousal emotions, r = 0.13, p = 0.02). In line with the anomalous emotional embodiment documented in individuals with schizophrenia, some of these differences were particularly notable for low-arousal emotions. Discussion These results reveal negative schizotypy as a significant correlate of differences in emotional embodiment. More work is needed to link these differences to the anomalous bodily sensations of emotions documented in schizophrenia and assess their functional impact.
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Affiliation(s)
- Lénie J. Torregrossa
- Department of Psychology, Vanderbilt University, Nashville, TN, United States
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Scott D. Blain
- Department of Psychology, Vanderbilt University, Nashville, TN, United States
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Matthew A. Snodgress
- Department of Psychology, Vanderbilt University, Nashville, TN, United States
- Department of Psychology, University of Minnesota, Minneapolis, MN, United States
| | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN, United States
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13
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Barca L, Candidi M, Lancia GL, Maglianella V, Pezzulo G. Mapping the mental space of emotional concepts through kinematic measures of decision uncertainty. Philos Trans R Soc Lond B Biol Sci 2023; 378:20210367. [PMID: 36571117 PMCID: PMC9791479 DOI: 10.1098/rstb.2021.0367] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 08/09/2022] [Indexed: 12/27/2022] Open
Abstract
Emotional concepts and their mental representations have been extensively studied. Yet, some ecologically relevant aspects, such as how they are processed in ambiguous contexts (e.g., in relation to other emotional stimuli that share similar characteristics), are incompletely known. We employed a similarity judgement of emotional concepts and manipulated the contextual congruency of the responses along the two main affective dimensions of hedonic valence and physiological activation, respectively. Behavioural and kinematics (mouse-tracking) measures were combined to gather a novel 'similarity index' between emotional concepts, to derive topographical maps of their mental representations. Self-report (interoceptive sensibility, positive-negative affectivity, depression) and physiological measures (heart rate variability, HRV) have been collected to explore their possible association with emotional conceptual representation. Results indicate that emotional concepts typically associated with low arousal profit by contextual congruency, with faster responses and reduced uncertainty when contextual ambiguity decreases. The emotional maps recreate two almost orthogonal axes of valence and arousal, and the similarity measure captures the smooth boundaries between emotions. The emotional map of a subgroup of individuals with low positive affectivity reveals a narrower conceptual distribution, with variations in positive emotions and in individuals with reduced arousal (such as those with reduced HRV). Our work introduces a novel methodology to study emotional conceptual representations, bringing the behavioural dynamics of decision-making processes and choice uncertainty into the affective domain. This article is part of the theme issue 'Concepts in interaction: social engagement and inner experiences'.
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Affiliation(s)
- Laura Barca
- Institute of Cognitive Sciences and Technologies, National Research Council, 00185 Rome, Italy
| | - Matteo Candidi
- Department of Psychology, University of Rome ‘La Sapienza’, 00185 Rome, Italy
| | - Gian Luca Lancia
- Institute of Cognitive Sciences and Technologies, National Research Council, 00185 Rome, Italy
| | - Valerio Maglianella
- Department of Psychology, University of Rome ‘La Sapienza’, 00185 Rome, Italy
| | - Giovanni Pezzulo
- Institute of Cognitive Sciences and Technologies, National Research Council, 00185 Rome, Italy
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14
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Wainio-Theberge S, Armony JL. Antisocial and impulsive personality traits are linked to individual differences in somatosensory maps of emotion. Sci Rep 2023; 13:675. [PMID: 36635384 PMCID: PMC9837047 DOI: 10.1038/s41598-023-27880-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/09/2023] [Indexed: 01/14/2023] Open
Abstract
Somatosensory experience is an important component of emotion, playing a prominent role in many traditional emotion theories. Nonetheless, and despite the extensive literature on the influence of individual differences in emotional processing, the relation between personality traits and emotion-related somatosensation has received little attention. Here, we addressed this question in a large sample of healthy individuals through the "bodily maps of emotion" behavioural paradigm, in which participants indicated the location and extent of their body sensations for the 6 basic and 4 additional social emotions (contempt, envy, pride, shame). We found that emotional somatosensation in specific body areas, including the heart, the stomach, and the head, was related to specific personality factors, particularly antisocial attitudes and impulsivity. Moreover, the similarity of individual participants' maps to the group-average was likewise negatively correlated with antisocial tendencies. Overall, our results suggest that differences in individuals' sensitivity to somatosensation from different body areas, as well as the typicality of their topographical patterns, may partly underlie variation in higher-order social and affective traits.
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Affiliation(s)
- Soren Wainio-Theberge
- grid.412078.80000 0001 2353 5268Douglas Mental Health University Institute, 6875 LaSalle boulevard, Verdun, QC H4H 1R3, Canada ,grid.14709.3b0000 0004 1936 8649Integrated Program in Neuroscience, McGill University, Montreal, QC Canada
| | - Jorge L. Armony
- grid.412078.80000 0001 2353 5268Douglas Mental Health University Institute, 6875 LaSalle boulevard, Verdun, QC H4H 1R3, Canada ,grid.14709.3b0000 0004 1936 8649Integrated Program in Neuroscience, McGill University, Montreal, QC Canada ,grid.14709.3b0000 0004 1936 8649Department of Psychiatry, McGill University, Montreal, QC Canada
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15
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Bradley LA, Combes L, Perry A, Brooks R. ‘Client's perspectives and the efficacy of Dramatherapy for Early Psychosis’. PSYCHOSIS 2022. [DOI: 10.1080/17522439.2022.2141843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Lauren A. Bradley
- Aspire (Early Intervention in Psychosis), Community Links, Leeds, West Yorkshire, UK
| | - Louise Combes
- Aspire (Early Intervention in Psychosis), Community Links, Leeds, West Yorkshire, UK
| | - Alex Perry
- Aspire (Early Intervention in Psychosis), Community Links, Leeds, West Yorkshire, UK
| | - Remennie Brooks
- Aspire (Early Intervention in Psychosis), Community Links, Leeds, West Yorkshire, UK
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16
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Herman AM, Zaremba D, Kossowski B, Marchewka A. The utility of the emBODY tool as a novel method of studying complex phenomena-related emotions. Sci Rep 2022; 12:19884. [PMID: 36400810 PMCID: PMC9674849 DOI: 10.1038/s41598-022-23734-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 11/04/2022] [Indexed: 11/19/2022] Open
Abstract
Bodily sensations are one of the major building blocks of emotional experience. However, people differ in their ability to recognise and name their emotions, especially those in response to complex phenomena such as climate change or the COVID-19 pandemic. Therefore, we investigated whether the bodily sensation maps (BSMs) approach can be employed to study emotions related to phenomena that are likely to evoke various, and perhaps even conflicting, emotions in people. Using a unique topographical self-report method-the previously established emBODY tool, 548 participants marked where in the body they feel sensations (activations and deactivations) when they experience distinct emotions (e.g. happiness) and when they think about different phenomena, namely climate change, COVID-19 pandemic, war, nature, friends, and summer holidays. We revealed maps of bodily sensations associated with different emotions and phenomena. Importantly, each phenomenon was related to a statistically unique BSM, suggesting that participants were able to differentiate between feelings associated with distinct phenomena. Yet, we also found that BSMs of phenomena showed some similarity with maps of emotions. Together, these findings indicate that the emBODY tool might be useful in uncovering the range of emotions individuals experience towards complex phenomena.
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Affiliation(s)
- Aleksandra M. Herman
- grid.419305.a0000 0001 1943 2944Laboratory of Brain Imaging (LOBI), Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, 02-093 Warsaw, Poland
| | - Dominika Zaremba
- grid.419305.a0000 0001 1943 2944Laboratory of Brain Imaging (LOBI), Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, 02-093 Warsaw, Poland
| | - Bartosz Kossowski
- grid.419305.a0000 0001 1943 2944Laboratory of Brain Imaging (LOBI), Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, 02-093 Warsaw, Poland
| | - Artur Marchewka
- grid.419305.a0000 0001 1943 2944Laboratory of Brain Imaging (LOBI), Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, 02-093 Warsaw, Poland
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17
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Nummenmaa L. Mapping emotions on the body. Scand J Pain 2022; 22:667-669. [PMID: 36151615 DOI: 10.1515/sjpain-2022-0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 07/16/2022] [Indexed: 11/15/2022]
Abstract
Emotions are allostatic processes that transform the relationship between the environment and the desired bodily states into behaviour supporting homeostasis and well-being. Central emotion circuits are thus tightly coupled with the visceral signaling pathways and the autonomic nervous system (ANS). Although ANS activity patterns are not always emotion-specific, self-reported bodily sensations and pattern recognition analysis of functional magnetic resonance imaging data suggest discrete bodily and neural basis of emotions. The advent of total-body positron emission tomography (PET) systems allows simultaneous measurement of the central and peripheral axis of the emotional response. This provides a unique opportunity for quantifying the systems-level biology of the human emotion circuits.
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Affiliation(s)
- Lauri Nummenmaa
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Psychology, University of Turku, Turku, Finland
- Turku University Hospital University of Turku, Turku, Finland
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18
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Schizophrenia in the flesh: Revisiting schizophrenia as a disorder of the bodily self. Schizophr Res 2022; 242:113-117. [PMID: 34996674 DOI: 10.1016/j.schres.2021.12.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 11/21/2022]
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19
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Cay M, Gonzalez-Heydrich J, Teicher MH, van der Heijden H, Ongur D, Shinn AK, Upadhyay J. Childhood maltreatment and its role in the development of pain and psychopathology. THE LANCET. CHILD & ADOLESCENT HEALTH 2022; 6:195-206. [PMID: 35093193 PMCID: PMC10364973 DOI: 10.1016/s2352-4642(21)00339-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 06/14/2023]
Abstract
Childhood maltreatment represents a form of trauma capable of altering fundamental neurobiological properties and negatively impacting neurodevelopmental processes. An outcome of childhood maltreatment is the emergence of psychopathology, which might become evident during childhood or adolescence, but might also project into adulthood. In this Review, we propose a biobehavioural framework in which childhood maltreatment and the associated aberrant neurobiological mechanisms and behavioural processes additionally lead to the onset of altered pain processing and, ultimately, the existence of pain syndromes. Considering that subpopulations of maltreated children show preserved function and minimal psychiatric or pain symptoms, compensatory mechanisms-perhaps instilled by robust psychosocial support systems-are also discussed. We present validated tools and experimental methods that could facilitate better comprehension of the interactions between childhood maltreatment, psychopathology, and pain. Such tools and approaches can in parallel be implemented to monitor abnormal pain-related processes and potentially guide early intervention strategies in cases of childhood maltreatment.
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Affiliation(s)
- Mariesa Cay
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | | | - Martin H Teicher
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA; Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
| | - Hanne van der Heijden
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Faculty of Science, Biomedical Sciences Neurobiology, University of Amsterdam, Amsterdam, Netherlands
| | - Dost Ongur
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA; Schizophrenia and Bipolar Disorder Program, Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA
| | - Ann K Shinn
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA; Schizophrenia and Bipolar Disorder Program, Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA
| | - Jaymin Upadhyay
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
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20
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Torregrossa LJ, Amedy A, Roig J, Prada A, Park S. Interoceptive functioning in schizophrenia and schizotypy. Schizophr Res 2022; 239:151-159. [PMID: 34891079 DOI: 10.1016/j.schres.2021.11.046] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/06/2021] [Accepted: 11/27/2021] [Indexed: 12/31/2022]
Abstract
Though bodily self-disturbances are well documented in schizophrenia, interoceptive functioning (i.e., the perception of the internal state of the body) remains poorly understood in this population. In fact, only two studies to date have empirically measured interoceptive ability in schizophrenia. Both studies documented a deficit in interoceptive accuracy (i.e., the objective performance on a heartbeat detection task), and one noted differences in interoceptive sensibility (i.e., the subjective experience of interoception) in this population. To our knowledge, interoceptive awareness (i.e., the metacognitive awareness of one's interoceptive ability) has never been measured in schizophrenia and the link between interoceptive functioning and schizotypy remains unexplored. The present study addresses this gap by investigating the three dimensions of interoception in individuals with schizophrenia and matched controls (Experiment 1, N = 58) and in relation to schizotypal traits (Experiment 2, N = 109). Consistent with the literature, Experiment 1 documented a deficit in interoceptive accuracy and differences in interoceptive sensibility in individuals with schizophrenia. For the first time, our study revealed intact interoceptive awareness in individuals with schizophrenia. Against our expectations, we found no link between schizotypy and interoceptive functioning in Experiment 2. Our novel findings bear important clinical implications as insight into one's interoceptive limitations (i.e., intact interoceptive awareness) might promote treatment seeking behavior in schizophrenia. The lack of association between interoceptive ability and schizotypy in non-help-seeking youths suggests that changes in interoception may only arise with the onset of psychosis.
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Affiliation(s)
| | - Amad Amedy
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Jacqueline Roig
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Andrea Prada
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
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21
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Davey S, Halberstadt J, Bell E. Where is emotional feeling felt in the body? An integrative review. PLoS One 2021; 16:e0261685. [PMID: 34936672 PMCID: PMC8694467 DOI: 10.1371/journal.pone.0261685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 12/07/2021] [Indexed: 11/22/2022] Open
Abstract
Contemporary research on "embodied emotion" emphasizes the role of the body in emotional feeling. The evidence base on interoception, arguably the most prominent strand of embodied emotion research, places emphasis on the cardiac, respiratory and gastrointestinal systems. In turn, interoception has evidence-based links with improved emotion regulation. Despite the focus on separate bodily systems, it is unclear whether particular interoceptive locations play a greater role in emotional feeling and emotion regulation. Further, according to Gross' "process model", the sooner that regulation of an emotion occurs, the better; hence, it is additionally important to identify the first body areas to activate. These issues are investigated in a two-stage integrative review. The first stage was preliminary, giving an overview of the evidence base to highlight the distribution of measured body areas. This indicated that 86% of publications (n = 88) measured cardiac activity, 26% measured the respiratory system, and six percent the gastrointestinal system. Given the emphasis placed on all three systems in interoception theory and research on emotion, this suggests a dearth of comprehensive findings pertaining to feeling locations. The second stage investigated the core issues of where emotional feelings are felt in the body and time-related implications for regulation. This was based on ten texts, which together suggested that the head, throat and chest are the most consistently detected locations across and within numerous emotional contexts. Caution is required, however, since-among other reasons discussed-measurement was not time-restricted in these latter publications, and direct physiological measurement was found in only a minority of cases.
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Affiliation(s)
- Steven Davey
- Department of Psychological Medicine, University of Otago Wellington, Wellington, New Zealand
| | | | - Elliot Bell
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
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22
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Barbato M, Arora T, Al Hemeiri S, AlJassmi MA. Looking within: Interoceptive sensibility in young adults with psychotic-like experiences. Early Interv Psychiatry 2021; 15:1705-1712. [PMID: 33442933 DOI: 10.1111/eip.13117] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 12/13/2020] [Accepted: 01/04/2021] [Indexed: 02/06/2023]
Abstract
AIM Interoception is the ability to sense internal bodily changes and research indicates that it may play a role in the development of mental illness. In recent years, preliminary evidence has shown that interoception is impaired in people with psychosis. Interoceptive sensibility, a meta-cognitive aspect of interoception, has never been studied across the psychosis continuum. The present study aimed at assessing interoceptive sensibility in youth with psychotic-like experiences. METHOD We invited a sample of young adults (N = 609; age 19-21 years) to complete an online survey that included a measure of interoceptive sensibility (the Multidimensional Assessment of Interoceptive Awareness-2) and the Community Assessment of Psychotic Experiences-Positive Scale -15 (CAPE-P15). Using the recommended cutoff for the CAPE-P15, the overall sample was divided into two groups (high/low risk for psychosis). RESULTS Significant group differences were observed in several dimensions of interoceptive sensibility. A logistic regression analysis indicated that scores in the subscales of Not-Distracting, Not-Worrying, Attention-Regulation, Emotional Awareness, Body Listening, and Trusting significantly predicted increased risk for psychosis. CONCLUSION Abnormal interoceptive sensibility may be a vulnerability marker for psychosis. These results, however, await further validation from additional comprehensive, longitudinal studies. Enhanced interoceptive sensibility has been reported following contemplative training, thus creating opportunities for future interventions to delay or prevent psychotic illness.
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Affiliation(s)
- Mariapaola Barbato
- Department of Psychology, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Teresa Arora
- Department of Psychology, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
| | | | - Maryam A AlJassmi
- Department of Psychology, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
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23
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Thomas L, Torregrossa L, Reniers R, Humpston C. Exploring multimodal hallucinations and disturbances in the basic and bodily self: A cross-sectional study in a non-clinical sample. J Psychiatr Res 2021; 143:144-154. [PMID: 34487991 DOI: 10.1016/j.jpsychires.2021.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/02/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
The bodily self is key to emotional embodiment, which is important for social functioning and emotion regulation. There is a paucity of research systematically assessing how basic and bodily self-disturbances relate to multimodal hallucinations. This study hypothesised that participants with greater hallucination-proneness would report greater degrees of basic and bodily self-disturbance and would demonstrate more ambiguous and less discrete mapping of emotional embodiment. Stage one screened non-clinical participants' degree of hallucination-proneness. Stage two participants completed seven further questionnaires. Hierarchical linear regression modelled the influence of hallucination-proneness and covariates on measures of basic and bodily self-disturbance and sensed presence. Stage two participants also completed a computerised body mapping task (EmBODY) which assessed emotional embodiment. Topographical maps were generated to compare patterns of embodiment between high and low hallucination-proneness groups. 55 respondents participated in stage two, with 18 participants from the high or low hallucination-proneness groups completing EmBODY. In the hierarchical regression analyses, the addition of a measure of hallucination proneness in the final step only increased predictive power where the dependent variable assessed sensed presence (p = 0.035 and p = 0.009, respectively). The EmBODY data revealed that participants with low hallucination-proneness consistently reported more bodily activation across 14 emotional states, whereas the high hallucination-proneness group reported more deactivation. In conclusion, hallucination-proneness was most strongly associated with sensed presence experiences. Patterns of embodiment appeared similar between the two groups, despite consistent differences in activation and deactivation. These findings are exploratory and need to be confirmed in a larger sample.
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Affiliation(s)
- Lucretia Thomas
- Medical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2GW, UK
| | - Lénie Torregrossa
- Department of Psychology, Vanderbilt University, Nashville, TN, 37240, USA
| | - Renate Reniers
- Institute of Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK; Institute for Mental Health, University of Birmingham, Birmingham, B15 2TT, UK
| | - Clara Humpston
- Institute for Mental Health, University of Birmingham, Birmingham, B15 2TT, UK.
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Melvin K, Crossley J, Cromby J. The feeling, embodiment and emotion of hallucinations in first episode psychosis: A prospective phenomenological visual-ecological study using novel multimodal unusual sensory experience (MUSE) maps. EClinicalMedicine 2021; 41:101153. [PMID: 34877510 PMCID: PMC8633969 DOI: 10.1016/j.eclinm.2021.101153] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 09/12/2021] [Accepted: 09/22/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Research and practice typically focus upon unimodal hallucinations, especially auditory verbal hallucinations. Contemporary research has however indicated that voice-hearing may co-occur within a broader milieu of feelings, and multimodal hallucinations may be more common than previously thought. METHODS An observational design asked participants to prospectively document the feeling and modality of hallucinations for one week prior to an interview. Novel visual diary methods involving drawing, writing and body-mapping generated 42 MUSE maps (multimodal unusual sensory experience), analysed with a participatory qualitative method. Twelve people took part: all experiencing hallucinations daily, accessing early intervention in psychosis services, given psychotic-spectrum diagnoses, and living in the community. The study took place during a seven-month period in 2018 at Leicestershire and Rutland's Psychosis Intervention and Early Recovery service (UK). FINDINGS All documented hallucinations co-occurred with bodily feelings. Feelings were localised to specific body areas, generalised across the body and extended beyond the body into peripersonal space. Co-occurring emotional feelings most commonly related to confusion, fear and frustration. INTERPRETATION Hallucinations were characterised by numerous feelings arising at once, often including multimodal, emotional, and embodied features. Within this study, the immediate feeling of hallucination experiences were readily communicated through prospective, visual, and ecological information gathering methods and particularly those which offer multiple modes of communication (e.g. body-map, visual, written, oral). Uptake of visual, ecological and prospective methods may enhance understandings of lived experiences of hallucinations.Funding: University of Leicester.
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Affiliation(s)
- Katie Melvin
- University of Leicester, Department of Neuroscience, Psychology and Behaviour, George Davies Centre, University of Leicester, 15 Lancaster Road, Leicester, LE1 7HA
- Leicestershire Partnership National Health Service (NHS) Trust, George Davies Centre, University of Leicester, 15 Lancaster Road, Leicester, LE1 7HA
- University of Leicester, Division of Innovation, Technology and Operations, Brookfield Campus, 266 London Road, Leicester, LE2 1RQ
- Corresponding Author
| | - Jon Crossley
- University of Leicester, Department of Neuroscience, Psychology and Behaviour, George Davies Centre, University of Leicester, 15 Lancaster Road, Leicester, LE1 7HA
- Leicestershire Partnership National Health Service (NHS) Trust, George Davies Centre, University of Leicester, 15 Lancaster Road, Leicester, LE1 7HA
| | - John Cromby
- University of Leicester, Division of Innovation, Technology and Operations, Brookfield Campus, 266 London Road, Leicester, LE2 1RQ
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25
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Brewer R, Murphy J, Bird G. Atypical interoception as a common risk factor for psychopathology: A review. Neurosci Biobehav Rev 2021; 130:470-508. [PMID: 34358578 PMCID: PMC8522807 DOI: 10.1016/j.neubiorev.2021.07.036] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/09/2021] [Accepted: 07/31/2021] [Indexed: 02/06/2023]
Abstract
The inadequacy of a categorial approach to mental health diagnosis is now well-recognised, with many authors, diagnostic manuals and funding bodies advocating a dimensional, trans-diagnostic approach to mental health research. Variance in interoception, the ability to perceive one's internal bodily state, is reported across diagnostic boundaries, and is associated with atypical functioning across symptom categories. Drawing on behavioural and neuroscientific evidence, we outline current research on the contribution of interoception to numerous cognitive and affective abilities (in both typical and clinical populations), and describe the interoceptive atypicalities seen in a range of psychiatric conditions. We discuss the role that interoception may play in the development and maintenance of psychopathology, as well as the ways in which interoception may differ across clinical presentations. A number of important areas for further research on the role of interoception in psychopathology are highlighted.
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Affiliation(s)
- Rebecca Brewer
- Department of Psychology, Royal Holloway, University of London, United Kingdom
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom.
| | - Geoffrey Bird
- Department of Experimental Psychology, University of Oxford, United Kingdom; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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Arioli M, Cattaneo Z, Ricciardi E, Canessa N. Overlapping and specific neural correlates for empathizing, affective mentalizing, and cognitive mentalizing: A coordinate-based meta-analytic study. Hum Brain Mapp 2021; 42:4777-4804. [PMID: 34322943 PMCID: PMC8410528 DOI: 10.1002/hbm.25570] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/10/2021] [Accepted: 06/15/2021] [Indexed: 01/10/2023] Open
Abstract
While the discussion on the foundations of social understanding mainly revolves around the notions of empathy, affective mentalizing, and cognitive mentalizing, their degree of overlap versus specificity is still unclear. We took a meta-analytic approach to unveil the neural bases of cognitive mentalizing, affective mentalizing, and empathy, both in healthy individuals and pathological conditions characterized by social deficits such as schizophrenia and autism. We observed partially overlapping networks for cognitive and affective mentalizing in the medial prefrontal, posterior cingulate, and lateral temporal cortex, while empathy mainly engaged fronto-insular, somatosensory, and anterior cingulate cortex. Adjacent process-specific regions in the posterior lateral temporal, ventrolateral, and dorsomedial prefrontal cortex might underpin a transition from abstract representations of cognitive mental states detached from sensory facets to emotionally-charged representations of affective mental states. Altered mentalizing-related activity involved distinct sectors of the posterior lateral temporal cortex in schizophrenia and autism, while only the latter group displayed abnormal empathy related activity in the amygdala. These data might inform the design of rehabilitative treatments for social cognitive deficits.
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Affiliation(s)
- Maria Arioli
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Zaira Cattaneo
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.,IRCCS Mondino Foundation, Pavia, Italy
| | | | - Nicola Canessa
- ICoN center, Scuola Universitaria Superiore IUSS, Pavia, Italy.,Istituti Clinici Scientifici Maugeri IRCCS, Cognitive Neuroscience Laboratory of Pavia Institute, Pavia, Italy
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Lloyd CS, Stafford E, McKinnon MC, Rabellino D, D'Andrea W, Densmore M, Thome J, Neufeld RWJ, Lanius RA. Mapping alexithymia: Level of emotional awareness differentiates emotion-specific somatosensory maps. CHILD ABUSE & NEGLECT 2021; 113:104919. [PMID: 33476805 DOI: 10.1016/j.chiabu.2020.104919] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Emotions have been associated with culturally universal and distinct bodily sensation "maps". Despite this knowledge, to date few studies have explored emotion-specific topography along clinically relevant dimensions, such as alexithymia. OBJECTIVE We aimed to investigate emotion-specific topographies among individuals exposed to childhood maltreatment or neglect with absent (n = 51) or with probable (n = 46) alexithymia in adulthood, as defined by scores on the Toronto Alexithymia Scale (TAS-20). PARTICIPANTS AND SETTING Ninety eight adult participants with exposure to childhood maltreatment or neglect were recruited to complete an online survey. METHODS Using the well-validated emBODY tool (Nummenmaa et al., 2014), participants reported on their somatic experience of 17 emotions. RESULTS Random effects analyses revealed topographically distinct bodily sensation t-maps that differentiated participants who endorsed probable alexithymia from those who did not (p-FDR < .05). Consistent with our a priori hypothesis, the probable alexithymia group reported a muted, diffuse and undifferentiated pattern of emotion-specific bodily sensation, whereas the non-alexithymia group reported a more distinct and localized pattern. CONCLUSIONS These results suggest that difficulty identifying and labeling emotions, as observed in alexithymia, may arise, in part, from an altered perception of somatic activation. It is well-established that childhood maltreatment predicts the development of alexithymia symptoms. The preliminary findings presented here expand our working understanding of the physical markers of childhood trauma, which may be used in practice to aid detection and to monitor treatment outcomes.
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Affiliation(s)
- Chantelle S Lloyd
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, Ontario, Canada; Department of Psychiatry, Western University, London, Ontario, Canada; Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada; Homewood Research Institute, Homewood Health, Guelph, Ontario, Canada
| | - Erin Stafford
- The New School for Social Research, New York, NY, USA
| | - Margaret C McKinnon
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada; Homewood Research Institute, Homewood Health, Guelph, Ontario, Canada
| | - Daniela Rabellino
- Department of Psychiatry, Western University, London, Ontario, Canada; Imaging Department, Lawson Health Research Institute, London, Ontario, Canada
| | | | - Maria Densmore
- Department of Psychiatry, Western University, London, Ontario, Canada; Imaging Department, Lawson Health Research Institute, London, Ontario, Canada
| | - Janine Thome
- Department of Psychiatry, Western University, London, Ontario, Canada; Department of Theoretical Neuroscience, Heidelberg University, Heidelberg, Germany
| | - Richard W J Neufeld
- Department of Psychiatry, Western University, London, Ontario, Canada; Department of Psychology, Western University, London, Ontario, Canada; Department of Neuroscience, Western University, London, Ontario, Canada
| | - Ruth A Lanius
- Department of Psychiatry, Western University, London, Ontario, Canada; Department of Neuroscience, Western University, London, Ontario, Canada; Imaging Department, Lawson Health Research Institute, London, Ontario, Canada; Homewood Research Institute, Homewood Health, Guelph, Ontario, Canada.
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Tuominen L, DeCross SN, Boeke E, Cassidy CM, Freudenreich O, Shinn AK, Tootell RBH, Holt DJ. Neural Abnormalities in Fear Generalization in Schizophrenia and Associations With Negative Symptoms. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:1165-1175. [PMID: 33524600 DOI: 10.1016/j.bpsc.2021.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/04/2021] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Associative learning and memory processes, including the generalization of previously learned associations, may be altered in schizophrenia. Deficits in schizophrenia in stimulus generalization, one of the simplest forms of memory, could interfere with the ability to efficiently categorize related, similar information, potentially leading to impairments in daily functioning. METHODS To measure generalization in schizophrenia, 37 individuals with a nonaffective psychotic disorder and 32 demographically matched healthy control subjects underwent a Pavlovian fear conditioning and generalization procedure, which accounted for variation in perceptual ability across participants, while undergoing functional magnetic resonance imaging. Skin conductance and neural responses to conditioned (CS+), neutral (CS-), and generalization stimuli were measured. Explicit memory ratings reflecting successful generalization were also collected after the scanning, as well as measures of symptom severity. RESULTS Compared with healthy control subjects, individuals with nonaffective psychotic disorders showed significant deficits in fear generalization across multiple measurements, with impairments in memory ratings and reductions in activation and deactivation of the salience and default networks, respectively, during fear generalization. Moreover, in the psychotic disorder group, greater behavioral and neural abnormalities in generalization were associated with higher levels of negative symptoms. CONCLUSIONS Fear generalization is impaired in psychotic illness. Given that successful generalization relies on a dynamic balance between excitatory and inhibitory neurotransmission, these results reveal a potentially quantifiable mechanism linked to negative symptoms that can be investigated further in future human and experimental animal studies.
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Affiliation(s)
- Lauri Tuominen
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; Department of Psychiatry, Massachusetts General Hospital, Charlestown, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Stephanie N DeCross
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Emily Boeke
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Clifford M Cassidy
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - Oliver Freudenreich
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Ann K Shinn
- Harvard Medical School, Boston, Massachusetts; Psychotic Disorders Division, McLean Hospital, Belmont, Massachusetts
| | - Roger B H Tootell
- Harvard Medical School, Boston, Massachusetts; Department of Radiology, Harvard Medical School, Boston, Massachusetts; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts
| | - Daphne J Holt
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, Massachusetts; Harvard Medical School, Boston, Massachusetts; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts.
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Abstract
Abstract
Background
Emotions play a central role in mental disorder and especially in depression. They are sensed in the body, and it has recently been shown in healthy participants that these sensations can be differentiated between emotions. The aim of the current study was to assess bodily sensations for basic emotions induced by emotion eliciting pictures in depression.
Methods
30 healthy controls (HC), 30 individuals suffering from Major depressive disorder (MDD) without medication use (MDDnm) and 30 individuals with MDD with medication use (MDDm) were shown emotional and neutral pictures and were asked to paint areas in an empty body silhouette where they felt an increase or decrease in activation. Body sensation maps were then calculated and statistical pattern recognition applied.
Results
Results indicated statistically separable activation patterns for all three groups. MDDnm showed less overall activation than HCs, especially in sadness and fear, while MDDm showed stronger deactivation for all emotions than the other two groups.
Conclusions
We could show that emotion experience was associated with bodily sensations that are weaker in depression than in healthy controls and that antidepressant medication was correlated with an increased feeling of bodily deactivation. Results give insights into the relevance for clinicians to acknowledge bodily sensations in the treatment of depression.
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Body-maps of emotions in bilateral vestibulopathy. J Neurol 2020; 267:104-108. [PMID: 32556570 PMCID: PMC7718178 DOI: 10.1007/s00415-020-09888-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/01/2020] [Accepted: 05/04/2020] [Indexed: 11/18/2022]
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